SYRIA and IRAQ NEWS

Despite the capture of Sarrin on Monday by the YPG/FSA combined force, Islamic State (IS) fighters continue to penetrate into the town across the Euphrates river.

YPG Fighter Infront of Entrance to Sarrin

In an attack yesterday, Thursday, IS Jihadists in civilian clothes managed to get into the eastern side of Sarrin from the village of Serekaniye (not to be confused with the town of the same name) and to attack a school used by the YPG as a base.

The first IS fighter blew himself up and killed 7 YPG fighters in the blast.

In the subsequent gun battle, at least 8 x IS Jihadists were killed and in the fighting that lasted all day another 6 YPG fighters died, making 13 in all.

The YPG are querying why Turkish jets were flying over Kobane city and Sarrin between 9.00am and 11.00am while the attack was taking place, reflecting the deep suspicion that poisons any relationships between the Kurds and the Turks.

Another IS fighter who had been hiding in Sarrin since it was liberated also appeared and tried to engage the Kurds in a gun battle but was quickly eliminated.

Another large cache of weapons, including 72 hand grenades, and ammunition was recovered as a result.

On Thursday night, IS Jihadists based in Jarablous attacked YPG forces on the east bank of the Euphrates with artillery and heavy weaponry but the YPG and Birkan Al-Firat, the combined force, retaliated in kind until the attack was silenced.

Once again, the YPG has been accused of “human rights violations”, this time after a number of local men and youths were rounded up for questioning in Sarrin.

According to some reports from the town, which normally has an Arab population of 6,000, 150 young men and others between the ages of 15 and 60 were detained, “accused of being members of IS and driven off in trucks to Kobane city where the Kurds put dozens of the detained youths in YPG vehicles and drove around inside the town, beating them, insulting them and directing racist remarks at them”.

The reports went on: “In Sarrin the YPG had torched a number of houses after looting the belongings of their owners, who were also accused of being members of ISIS. Even the aged were not spared the aggression of those units”.

EDITOR: I have to say that I do not recognise this as YPG/YPJ behaviour at all, especially as Sunni Arab fighters from the FSA would have been present as well. That the YPG would round-up some locals for questioning as they may be IS sympathisers is understandable, but there is no record of the Kurds treating even IS prisoners badly and such behaviour would be against the whole published Rojavan philosophy of living in harmony with other races and religions.

You can read more of this supposed “inhuman behaviour” and make up your own mind, HERE:

You can see some of the YPG/FSA “mopping-up” operation against IS in Sarrin, courtesy of LiveLeaks, here:

Fighting continues in Hasakah with the YPG still taking the lead over Assad’s forces who seem largely impotent in stemming the Islamic State attacks.

According to latest information, the YPG is now in control of around 70% of the Al-Zuhour neighbourhood and have advanced southwards from the Nashwa area towards the Panorama district and into the southern portions of the city.

Not ones to sit on their hands, the Kurds in Cizire Canton and the north-east of Syria have reopened many of the oil-wells there in the Rmeilan oil field and started refining, albeit crudely, oil products such as gasoline, kerosene and heating oil for themselves for the first time. Until the start of the civil war, all the oil was sent to Assad refineries in Homs and Banias. You can read more, HERE:

Eric Scurfield’s Mother, With Jordan Matson, at the Graveside of the Killed Brit

Jordan Matson, the well-known American fighting with the YPG against IS has spoken to the BBC while passing through London.

Recently married in Sweden to a Kurdish woman, Matson expressed disappointment with the reaction of the Turks and the US in relation to the work done by the Kurds in Rojava and Sinjar (Shingal).

Jordan Matson was in the UK, along with other foreign fighters that had fought alongside the Kurds, for a ceremony to remember Eric Scurfield, an ex British Royal Marine killed in fighting with IS. The BBC again has a report.

Have not said much recently about the lovely ladies of the Kurdish YPJ, but this report celebrates their femininity and how they prepare themselves for battle with pride – to look like women and not men, HERE:

Worldwide, concern continues to be expressed about the real motives of Turkey in its sudden interest in “attacking IS” after 4 years of doing nothing, and its obsession with containing the Kurds – a worthy ally if they would allow them to be. The 2 year old peace process of discussions with the PKK is hanging by a thread – and may already be broken.

There have been no further reports of Turkish air attacks on Islamic State positions over the last 48 hours in either Syria or Iraq.

In Turkey itself, more than 1,000 people have been arrested as suspected members of the PKK or IS, however, the vast majority are Kurds and PKK members or sympathisers. 3 Turkish soldiers were earlier assassinated in retaliation for Kurdish deaths.

Human Rights Watch (HRW), has expressed concern for human rights in Turkey, which seem to be falling apart rapidly under Erdogan’s rule, HERE:

While Al-Aribya, the Huffington Post and Foreign Policy magazine have all expressed the same view that this moment is bad for Syria, bad for the Kurds, and the start of a black future for Turkey, in good articles worth reading.

YPJ Fighter Studies the Battlefield

OPPOSITION ALLIANCE, INCLUDING AL-NUSRA, OVERRUNS ASSAD’S POSITIONS ON THE GHAB PLAIN, BUT AL-NUSRA ATTACKS BOTH YPG AND OPPOSITION IN NORTHERN ALEPPO:

As if the Syrian situation is not complicated enough, clashes broke out yesterday, Thursday, in the western Kurdish Canton of Afrin in Aleppo province between the YPG and the Al-Nusra Front (ANF)

ANF fighters were accused of assaulting some villagers near Atama village and the town of Jenderis. When the YPG intervened to protect the villagers working on their farms, some elements of the ANF opened fire on local YPG checkpoints.

Al-Nusra Front Raises its Flag at Ariha in Aleppo Province

Fortunately, no-one was injured and the ANF fighters retreated to their bases in the northern Aleppo countryside.

A truce has been running between the 2 sides in the area for 6 months now, but this may have been an attempt to test the Kurdish reaction.

ANF is also accused of abducting earlier this week the leader and several members of “Division 30”, an Opposition group which has reputedly just received training abroad from the US under the “train and equip” programme.

The Division 30 base near Azaz in Aleppo province was also attacked at 4.30 am Friday morning and 7 Opposition members killed as they held off the attackers.

This was followed by airstrikes from the Coalition on ANF bases in the area, killing 18 of their fighters.

Jaish al-Thuwar, another Opposition group in the same region, said on Facebook today, Friday, that it had also clashed with ANF, losing 4 of its own members and killing 8 of the ANF attackers.

Quite what is going on here is anybody’s guess, but ANF in northern Aleppo had previously routed US-backed moderate groups. Does it have some arrangement with Turkey to secure the area in Aleppo Province to the northern border?

Near Aleppo city itself, 20 of Assad’s soldiers were killed after they attempted once again to retake the Science Research complex captured by the Opposition earlier this month. Assad’s forces attacked the complex from many sides but failed to make any headway, their own positions being pounded with rockets and Opposition heavy artillery.

Zeyzoun Thermal Power Plant

An Opposition alliance of fighters in Idlib province, including ANF, stormed ahead this week, capturing the Zeyzoun Thermal Power Plant, HERE:

In a desperate attempt to retake the plant today, Friday, unconfirmed reports say the Government side lost 3 tanks, a BMP armoured vehicle and around 40 troops.

This video shows more fighting today at the nearby Zeyzound Dam, HERE:

In fact a complete collapse of Assad’s forces seems to have taken place on the southern Ghab Plain, leaving all the routes over the mountains to Latakia extremely vulnerable. Regime fighters are seen fleeing Sheikh Elias on Tuesday, HERE:

In Damascus province in the Qalamoun, Opposition fighters continue to hold out against all the odds from a massive campaign by Hezbollah and Government troops. This week they have blown up several buildings used by Assad’s troops in the Zahra castle area, destroyed a tank in Bloudan and shot down a Hezbollah surveillance drone.

In Daraa, Opposition fighters are inside the city attacking the Air Force Intelligence building, HERE: and are clashing with Assad’s fighters infront of the National Hospital, HERE:

Lastly, from Quneitra province there are reports that an Israeli Defence Force drone took out a car in the foot hills of Mount Hermon near Hadar on Wednesday containing 2 members of Hezbollah and 3 men from the pro-Assad Druze “Popular Syrian Resistance”.

48 hours earlier it is said in unconfirmed reports, Israel also destroyed some Hezbollah missile and military sites near the Bekka Valley.

BETHLEHEM (Ma’an) — Senior PLO official Hanan Ashrawi on Thursday condemned the Israeli Knesset’s approval of a law that allows the force-feeding of Palestinian detainees on hunger strike.

“Such a law is a politically-motivated mechanism of torture which constitutes a flagrant violation of international law and conventions,” she said in a statement.

“According to the World Medical Assembly’s Declaration of Malta on Hunger Strikers of November 1991, ‘forcible feeding is never ethically acceptable,” she added.

“Even if intended to benefit, feeding accompanied by threats, coercion, force or use of physical restraints is a form of inhuman and degrading treatment.”

Ashrawi’s comments came during a meeting with British Consul General Alastair McPhail at the PLO headquarters in Ramallah.

Earlier, head of the Palestinian Authority Prisoner’s Affairs Committee, Issa Qaraqe, said the law is “unethical torture,” and noted that the policy killed three Palestinian detainees in 1980 during a hunger strike.

The law, which passed by 46 votes to 40, “will be used only if a doctor determines that the continued hunger strike will create an immediate risk to the life of a prisoner or long-term damage to his health,” David Amsalem of the ruling Israeli Likud party said.

The Israeli Medical Association called the law “damaging and unnecessary,” stressing on Thursday its doctors would “continue to act according to medical ethics, which prohibit doctors from participating in torturing prisoners”.

Physicians for Human Rights Israel said the “shameful” law revealed the “anti-democratic face” of the Israeli parliament, saying they would continue to oppose the law and its implementation, and “support anyone who will refuse to obey the law”.

The law, which seeks to prevent imprisoned Palestinian prisoners from pressuring Israel by refusing food, was initially approved in June 2014 at the height of a mass hunger strike of Palestinian detainees, during which dozens were hospitalized.

SYRIA and IRAQ NEWS

With the capture of Sarrin earlier this week, effectively, apart from raiding parties and isolated pockets, Kobane Canton is virtually “Islamic State-free” and now wholly returned to Kurdish administration.

YPG Fighter With Child Residents of Sarrin

Mopping up operations continue both within Sarrin and in the surrounding area.

Minor clashes between the combined YPG/FSA force and IS remnants were reported at the village of Sena’a on the M4 highway just north of Sarrin.

It was also reported that IS blew up part of the Sarrin Grain Silos, collapsing the main tower, before pulling out.

No decisive information as yet on the other pocket of resistance at Khirbat Al-Burj, but it is likely that the defending IS forces have fled the area.

Enormous amounts of ammunition and weapons were recovered from in and around Sarrin and the local population seem to be glad to see the return of the Kurds.

Around 80 Islamic State fighters are thought to have been killed in the Sarrin battles.

Coalition airstrikes picked off some IS units as they fled, while some got away by commandeering small boats to get across the Euphrates to the west bank.

As well as Sarrin town itself, more than 25 surrounding villages and 20 farms were also freed from IS domination and control. 19 members of the combined YPG/FSA Burkan al-Firat force died in the 3 week Sarrin campaign.

Weapons Captured from IS in Sarrin Campaign

Ongoing problems for the Canton remain, including the rebuilding of Kobane city.

While the food supply has improved since a link was established directly to Cizire Canton via Tal Abyad, the re-building programme is still stymied by a lack of fuel to drive vehicles and electricity generators. Al-Monitor discusses the issue.

If you would like to support the Kobane rebuilding programme there is a genuine crowdfunding site, called FireFund based in Denmark, attempting to raise $130,000.

(EDITOR: At my last look they had raise nearly $10,000 – please give it your support.)

Perhaps a new and ongoing problem for the Kurds in Kobane is attacks by the Turks.

As reported earlier (scroll down – see below), Turkey since it claimed to be attacking the PKK and the Islamic State from the 24th July, has twice attacked YPG and even FSA units in northern Syria. The YPG says it will retaliate if it is attacked again.

Interesting interview with Polat Can, who is the YPG’s representative with the International Coalition against IS,HERE:

In Hasakah city, violent clashes are still being reported between the YPG and the Islamic State, especially in the Al-Dhuhur district, while heavy airstrikes are occurring south of the city on IS positions and at nearby Shadadi.

Assad’s forces are shelling building used by IS in Shadadi and locals report many IS bodies in the streets in the Hasakah neighbourhood of Ghweran.

US Central Command (Centcom) reports 9 Coalition airstrikes on or near Hasakah from Monday through Wednesday this week, destroying 6 x IS fighting positions, an IS fighter staging position, an IS bunker, An IS motorcycle and another IS structure. 6 x IS tactical units were also struck in the attacks.

Another airstrike was on IS in Idlib, hitting a tactical unit and destroying an IS vehicle and 2 more in Aleppo province destroying an IS vehicle, 7 x IS fighting positions, an IS bunker and hitting 2 x IS tactical units.

TURKEY USING “THEY ARE ALL TERRORISTS” SLOGAN TO ATTACK MAINLY THE PKK AS WELL AS THE ISLAMIC STATE:

At the NATO meeting at its headquarters in Brussels on Tuesday, several NATO members urged Turkey not to abandon the 2 year fragile peace process that has been ongoing with the Kurdistan Workers Party (PKK) and whose leader, Abdullah Öcalan, has been imprisoned by the Turks since 1999.

Turkish Jets target Is and the PKK

While welcoming Turkey’s involvement against the Islamic State, several countries urged it to be proportionate in any retaliatory attacks against the PKK.

All of the most recent airstrikes however, have been against PKK bases in the northern Kurdistan region of Iraq.

Hours before the meeting, Turkey’s President, Recep Tayyip Erdoğan, on Monday said he could not continue a peace process with the Kurdish militants and called for Kurdish MPs in Parliament, with links to “terrorist groups”, to be stripped of their immunity against prosecution.

Erdogan it seems is using the opportunity of attacking the Islamic State to bomb the Kurds and at the same time prevent them connecting up Afrin Canton in western Aleppo province with Kobane Canton.

He is also sore that the Kurdish party in Turkey, the HDP, managed to cross the 10% of the vote threshhold and send 80 MPs into Parliament for the first time, preventing his own party, the AKP, from having an overall majority.

Unless a coalition can be formed, which is unlikely, then new elections will be called. Some think that his attacks on the Kurds are deliberate provocation to get them to retaliate and thereby produce resentment and a corresponding anti-Kurdish vote that will sweep his party back into dominate power.

Selahattin Demirtas, the popular leader of the Kurdish HDP party, says his party will forgo immunity against prosecution if Erdogan’s MPs will do the same.

He also has deep concerns over the proposed “safe zone” or “IS-free zone” to run 90 kilometres along the Syria Turkish border between Afrin Canton and Kobane. He sees it as an attempt to stop Kurdish unity, rather than the Islamic State. Demirtas can be seen in this interview with the BBC.

Fighters from the PKK were instrumental in saving thousands of Yezidi on Mount Sinjar from almost certain death at the hands of the Islamic State and the YPG, aligned to the PKK through its political wing, has driven IS away from the Turkish border. Syria’s Assyrian Christians have also requested that Turkey stop bombing the Kurds.

Interestingly, since July 24th when Turkey announced it was joining the attacks against IS and made the first strikes, the Assad regime has made almost no barrel-bomb attacks in Aleppo province, until now the area of highest bombing concentration. Turkey has said it will shoot down any Syrian aircraft that enter the “safe zone”.

The proposed “”safe zone” is something like this (below), with Afrin in the west and Kobane the green area in the east. Who and which units would be allowed to operate inside the “safe-zone” remains to be seen. Would the Al Nusra Front, to which Turkey seems sympathetic, be allowed? This would be an anathema to the US, who would only consider allowing “moderate Opposition” groups to operate in this protected area.

Gaza – a place where a child is being killed every hour, where 600 Palestinians have died and where 3,500 have been injured. Of the dead, 74% are civilians, including 147 children. More than 120,000 people have fled their homes but the borders are shut and people have nowhere safe to go.

44% of Gaza territory has now been declared areas that people must leave. The remaining 56% is also dangerous and faces frequent airstrikes.

Around 1.2 million people – two thirds of Gaza’s population – have no or very limited access to water and sanitation services. At least 18 medical facilities have been hit by airstrikes and shelling, including hospitals, ambulances and health clinics, while 90 schools have been damaged by shelling.

Half of Gaza’s bakeries are not operating and have stocks to last one more week. More than 135,000 people need food assistance. And at least 116,000 children need psychosocial care after their homes have been destroyed or they have had to flee or had family members killed.

These stark figures show how the conflict in Gaza and Israel is having particularly devastating consequences for civilians in Gaza, affecting every aspect of life. Gaza has been under Israeli blockade for the past seven years, which has devastated the economy, left most people unable to leave, and restricted access to essential services. The latest violence is making a dire situation even worse, and will have an impact on people’s lives and livelihoods for a long time to come.

Oxfam condemns all attacks on civilians by all sides, and is calling for an immediate ceasefire. Long term peace and security for Palestinians and Israelis alike will only come with a lasting solution that ends the blockade and ensures people in Gaza can have basic rights. The below photos by Mohammed Al Baba show what life is now like for people in Gaza:

The ongoing airstrikes have destroyed everything from family’s homes to fishermen’s boats, water systems to health centres. These agricultural greenhouses in Khan Younis, in the southern Gaza Strip, used to grow tomatoes, cucumbers, onions and pumpkins. They were destroyed in strikes earlier this week.

Dozens of fishing boats and more than 1,000 nets have been destroyed. Sabri Bakr’s family has been fishing for generations and it is his only source of income. “Before this military operation started, the situation was already very bad. Now my boat is totally burnt and I have nothing at all. I really do not know what will I do now, or how I will even provide food to my children.”

Years of restrictions on fishermen’s movement have left them struggling to make a living. Under the blockade they are only allowed a maximum of six nautical miles out at sea, and are frequently shot at or arrested by the Israeli navy even within the so-called “fishing zone.” Oxfam supports fishermen in Gaza with equipment and technical advice.

Doctors at the Oxfam-supported Al Awda Hospital in northern Gaza treat a young boy. The hospital is struggling to cope and faces chronic shortages of fuel, with Gaza suffering 12-16 hour daily power cuts under the blockade. “About 40 percent of the casualties we’ve treated are children, and our medical staff are working 24-hour shifts. If more fuel is not available the hospital will have to shut down many of its services,” said Ahmed Manna, Al Awda’s Medical Director.

One of Gaza’s busiest streets stands empty. Many shops and factories have closed and people are scared to go out. Su’ad, a mother of six, works at a food processing unit supported by Oxfam, producing pastries and other baked goods.

“My children and I are barely able to sleep due to the continuous airstrikes. We are in the middle of Ramadan – the holy month – which is usually our busiest and most profitable time of the year as people spend more money on food and gifts for relatives. This time last year we made $1,000 a week. But since the bombing started we haven’t been able to sell anything. Three of my children go to college and their tuition fees depend on the money I make during Ramadan.”

Amid the rising casualties, the Oxfam-supported Al Awda Hospital continues to deliver babies. The hospital is the only one in north Gaza with a specialized obstetric unit for pregnant women. Abeer Al Madhoun gave birth to a healthy young boy this week: “I was so scared to be targeted on my way to the hospital. During the delivery I heard bombs falling around the hospital. I was scared that my baby would be hurt. I’m thankful to the medical teams who are doing everything possible despite the danger surrounding them. My happiness is mixed with fear and sad feelings for the children who have lost their lives.”

Children in Rafah, southern Gaza, collect water from one of the working public taps. Numerous water systems and wells have been badly damaged in the airstrikes. Sewage plants have also been damaged, with millions of litres of raw sewage spilling into streets, farms and the sea. Even before the current escalation around 90 percent of water in Gaza was already unsafe to drink. The outflow of sewage risks further contaminating water supplies, increasing the threat of disease. Oxfam teams are running public health campaigns to try and reduce the risk.

Meleh Al Shaer grows pumpkins on his farm in the southern Gaza Strip. The farm was completely destroyed a few days ago. Thousands of farmers like Meleh have lost large amounts of land and produce – something it will take a long time to recover from. Oxfam supports farmers in Gaza with agricultural equipment and specialist advice.

Some shops have managed to stay open. Oxfam is providing food vouchers to hundreds of families who have been forced to flee their homes – so that they can buy food to eat and to support local businesses and trade.

Najwa, from Khan Younis, was approved for surgery in Amman, Jordan, after she was injured in a bomb blast

Stepping out of a car in the West Bank town of Kafr Qaddum, I was greeted by the stench of urine, feces, and burnt tires—a foul reminder of the near-constant confrontation between Israeli settlers and soldiers on one side, and Palestinians on the other.

The Abu Ehab family—whose two-story house is located on a slope just below the road we drove in on—is caught between these battles. They keep their chickens on the second floor and live on the first, but the walls do little to protect them from the exchange of tear gas, burning tires, and hurled rocks. The IDF frequently moves around the Abu Ehab family’s property during nighttime search operations; at times, they enter the house.

The smell comes from “skunk,” the sewage-smelling liquid that the Israeli Defense Forces (IDF) use to soak Palestinians and foreign protestors who gather weekly on this ashen road. It is so pungent that the family’s eldest son now vomits at the sight of food. The military also uses flash-bang grenades to counter the demonstrations. After one detonated too close to their home their eldest daughter lost hearing in one ear.

“She used to not be able to finish a sentence without crying,” the Doctors Without Borders/Médecins Sans Frontières (MSF) psychologist who has been counseling the girl’s mother tells me. “Now, she can talk about her fears without breaking down.”

This is how MSF, as a medical humanitarian organization, measures the progress of those we assist in the occupied Palestinian territories. For the past 15 years, ourprograms in the West Bank and Gaza have focused mainly on mental health—but my colleagues at times feel like they can only give patients a thicker coat of psychological armor against the daily trauma of their lives. These patients are parents of teenagers being held in Israeli or Palestinian prisons, children with one or both parents in detention, families on the frontlines of settler-Palestinian violence or intra-Palestinian violence, and those affected by nighttime IDF search operations or other military actions.

What our staff sees, day in and day out, are the medical consequences of the occupation. But while we can treat some of our patient’s symptom, we can’t alter the underlying causes of their suffering. And as the suffering has become normalized, we have been questioning the wisdom of our presence. This is the humanitarian’s dilemma: how to alleviate the suffering of a population while not enabling the powers at the root of the pain.

As we approach the one-year anniversary of the latest (but likely not the last) war in Gaza, it should be understood that humanitarian organizations do not hold a monopoly on this dilemma. All countries, and the United States and members of the European Union in particular, that condone and help extend the occupation of the Palestinian territories—whether by subsidizing it through humanitarian or military aid or giving political cover to its policies and practices—must confront their responsibility for the suffering of Palestinians.

Night Terrors

The Abu Ehab family’s experience is painfully unexceptional. For ten years, MSF has provided psychological care for Palestinians in and around the city of Nablus—and for much longer in other parts of the West Bank. We respond to the never ending implications of an occupation by offering care for the parents of teenagers detained in Israeli or Palestinian prisons; children whose father, mother, or both parents were detained; families on the frontline of settler-Palestinian violence or intra-Palestinian violence; and those affected by nighttime IDF search operations.

In the village of Majd al-Bani Fadil in the West Bank, there is a house with six children under the age of 18—three girls and three boys—who are all living alone. When I entered the home with an MSF psychological assessment team, the children’s uncles explained how each child had deteriorated since both their parents had been arrested in separate incidents—the mother taken away in the middle of the night—over the past year.

The eldest daughter cannot focus on her studies, the middle son now regularly hits his siblings for no apparent reason, and the middle daughter is often found crying in her parents’ old room. The mother has been detained by Israeli authorities for nearly a year without sentencing. This, one of their uncles told me, is the hardest part for the children: “They don’t have hope.”

Bureaucratic Violence

MSF has seen firsthand how the Israelis’ use of administrative detention—which does not require charges to be brought against those incarcerated—heightens the psychological violence inflicted on Palestinian children. The trauma of having a parent dragged off in the middle night is compounded by the uncertainty of when their mother or father might return home.

The separation of families is on the rise with the monthly average of Palestinians held by the Israeli authorities for alleged security offences increased by 24 percent in 2014. Data on Palestinian children in military detention show every month an average of 185 children were held in Israeli military custody in 2014, compared to 197 in 2013—a mere 6 percent decrease.

Three hundred and nineteen orders for administrative detention without charge or trial have been issued by Israeli occupation military courts since the beginning of 2015, according to the Palestinian Prisoners Center for Studies. This is an increase of 500 percent over the same period in 2014, when 51 orders were issued.

The anxiety from the nightly threats is palpable. Mothers in the communities we serve often send text messages to each other at the first sign of a search operation, and many frantically wake up their children in the middle of night and get them fully clothed to avoid soldiers breaking in the front door or simply entering the home while everyone is still in their pajamas.

The Body Does Not Lie

The events most often brought up by MSF patients include a violent IDF search operation inside their home (52 percent); current incarceration of one or multiple family members (42 percent); or indirect violence such as shooting or incursion operations by IDF (35 percent).

The presence of the Israeli army in the West Bank—and its constant use of force in most of the events they are involved in—is the main cause of the psychological trauma of our patients. Furthermore, twenty percent of our patients live close to a settlement and are therefore constantly exposed to stress. This is the psychological damage of the perpetual siege situation the population in the West Bank lives in.

The children are the worst, most easily affected. Fifty percent of our patients are younger than 15; 25 percent are below the age of 10. Among the most common symptoms are sleeping disorders (50 percent); anxiousness (34 percent); difficulty concentrating (28 percent); aggressiveness (23 percent) and bed wetting (21 percent). Even our most seasoned psychologists are shocked by the levels of trauma.

Occupied Minds

The mental health disorders we see in the West Bank are in many ways a reflection of the dynamics of the conflict.

In 2014, Israeli forces were implicated in the highest number of Palestinian fatalities since 2007, and the highest number of Palestinian injuries since 2005, when the UN’s Office for the Coordination of Humanitarian Assistance first started collecting data. Violence peaked in the second part of the year, following the abduction and killing of three Israeli youths and the retaliatory killing of a Palestinian youth in East Jerusalem in July.

The number of child casualties recorded in the West Bank caused by Israeli forces increased sharply: 13 were killed in 2014, compared to four in 2013, the highest number since 2006. Palestinian attacks against Israeli civilians (mostly settlers) and security forces also rose in 2014, with Israeli fatalities increasing from four to 12.

In mid-2014, Israel resumed the practice of punitive demolitions throughout the West Bank, after an almost complete halt for the previous nine years. This practice targets the family homes of perpetrators, or alleged perpetrators, of attacks against Israeli civilians and security forces. Four houses were destroyed and one was sealed in 2014, displacing at least 27 people, amounting to a collective punishment.

Intimate Violence

Residents of Hebron, in the south of the West Bank, endure indignities that are as relentless as they are intimate. Violence between Palestinian and Israeli communities breaks out on a daily basis. When I traveled to Hebron, it was Israeli Independence Day—otherwise known as “Nakba” day, the “catastrophe” created by the forced displacement of Palestinians. Settlers had draped the Israeli flag over the central mosque. The day after a Palestinian teenager stabbed an Israeli soldier and then was killed.

On the top of a hill overlooking the old city, I met a Palestinian woman, a patient at our counseling program. Afflicted with diabetes, hypertension, and poor circulation, she has been in and out of the public hospital for several years. After having caught my breath from scaling the hill to her home, I listened as she told me how her family has lived here for more than 70 years, and how, in 1984, a settlement was built in the area just outside her front door.

Since 2003, she and her family have not been able to use their front gate. Instead, when she needs to go to the hospital—or has to leave her house at all—she has to leave through her back door and walk down a dirt path littered with trash from the settlement—a path that floods when it rains—to reach either an ambulance or her latest, beaten-up car (her five previous vehicles were destroyed by settlers). To get to the market, a trip that used to take her five minutes, her daughter now must take a circuitous route that takes nearly half an hour.

Not only can she not exit through her front gate; she also can’t prevent outsiders from using it to get into her yard. The IDF recently told her she was no longer allowed to connect to the municipality’s sewage line as well.

As I prepared to leave her home, she whispered to me through our translator, “I have been to Chicago but never to Gaza.”

The Misery of Gaza

She’s not alone. Palestinians living in the ever-shrinking livable tracts of the West Bank are almost universally forbidden from travelling to Gaza. It’s hard to imagine they’d find it any more hospitable, though, if they traded the daily confrontation and oppression they know for the sense of deprivation and siege that pervades Gaza.

If West Bank Palestinians were able to visit Gaza, they’d see, as I did when walking through Beit Hanoun in the northern reaches of the strip, that it seems as if last summer’s war just ended. They’d see that not a single totally destroyed structure has been rebuilt since the IDF launched its military operation on the Gaza strip for 50 days last July and August.

To the extent that the war is still spoken of outside the immediate region, much of the public debate—and the near weekly UN and human rights reports—remains focused on the conduct of the fighters and the nature of the hostilities on both sides. These investigations are important, but they shouldn’t mask the ongoing misery in Gaza.

Numbers tell part of the story of the war’s impact. Seventy-one Israelis were killed, according to the Israeli government, including five civilians. According to the U.N. Independent Commission of Inquiry into the 2014 Gaza conflict, 2,251 Palestinians were killed, including 1,462 civilians, of whom 299 were women and 551 were children. Some 11,231 Palestinians were also injured , including 3,540 women and 3,436 children.

MSF’s postoperative clinic remained open during the war, functioning with minimal human resources capacity, accepting around 95 new cases from July 15 – August 24, 2014 and providing follow-up care to critical patients who had already been admitted. To prevent patients from having to return to the clinic during the bombardment, a dressing kit was given to each patient for self-care.

The vast majority of the wounded were treated by Palestinian medical personnel and transported at great risk, as the casualties attest, by Palestinian Red Crescent aid workers to the network of public health facilities in Gaza.

Additional MSF surgical and emergency teams that were able to enter Gaza the first week of the conflict immediately got to work in the main surgical units, intensive care unit, and ER in al-Shifa and Nasser hospitals. MSF teams were also able to support the burn unit in al-Shifa hospital, operating on more than 80 patients in August. Due to the massive influx of patients in July it was impossible to keep exact records of the numbers of patients treated.

Time Standing Still

Teetering atop half demolished buildings, Palestinians are reduced to scavenging rebar and copper wire from piles of wreckage. Anything they can reuse is valuable given the ongoing Israeli blockade of Gaza, which was bolstered last October when Egypt closed the Rafah Crossing in southern Gaza and destroyed the smuggling tunnels that ran beneath it, which had provided a lifeline to Gazans. Now many basic materials that Israel fears would be put to military use—so-called “dual-use” materials—cannot be imported into Gaza at all, from cement to rebar. Even wood for construction is now considered as dual-use material, and, therefore must be processed through the Israeli security mechanism. Sand is used to thicken what small amount of cement has gotten into Gaza.

The human costs of this status quo are real. MSF clinics in Gaza City and Khan Younis are full of children who suffered severe burns in household cooking accidents in home damaged during the war. Some of our patients have been burned from explosions caused by the use of unsafe home heating products. In April, 70 percent of total cases treated at MSF facilities in Gaza were burn victims with 65 percent being children under the age of 15.

Others still need more reconstructive surgery or physiotherapy for injuries from last summer’s war, including an eight-year-old girl that I met in our post-operative clinic in Gaza City, who lost most of the use of her extremities after shrapnel from an Israeli missile lodged in her back. She will likely only regain 50% percent of her orthopedic functions.

She is one of many. The backlog of reconstructive surgical cases now reaches 300. And for those amputees lucky enough to return to an undamaged home, daily life will still be incredibly precarious. Imagine trying to steer a wheelchair down a street lined with huge chunks of shattered buildings.

At our post-operative clinic in Gaza City, screams emanate from children receiving wound dressings for their burns, without the benefit of any pain killers. The scene is yet another example of how the suffering inflicted from latest war here continues to exact a toll on Palestinians. And it lays bare the visceral and excruciating limits of humanitarian action in the face of the occupation.

Why Bother With Hope?

A frightening, miserable sort of normalcy, bereft of hope or future prospects, has set into daily life in Gaza. War is thought to be almost as inevitable as the passing seasons. A 10-year-old child here has seen war four times in his or her lifetime. And with each war the toll escalates: 12,410 houses were totally destroyed in 2014 compared to 3,425 homes in 2009.

Rockets are again being tested and fired from Gaza into Israel, drawing thunderous responses from the Israelis. These violent acts – called acts of resistance on one side and terrorism on the other – serve to reinforce the acceptance of a policy of separation and isolation of Israelis and Palestinians, and the further de-humanization of the “others,” a dynamic that has only accelerated since the second intifada.

In recent weeks, small improvised explosive devises have been set off in the streets of Gaza at night and in the morning. Thankfully there have been no casualties but many are wondering if the attacks might signal the start of a new round of intra-Palestinian conflict, should reconciliation talks between Hamas and the Palestinian Authority flounder.

Petty crimes are on the rise, too, as the noose—man-made and natural—continues to tighten around Gaza. In less than a year it is expected that the Mediterranean will penetrate Gaza’s lone aquifer and make it undrinkable, while its fishermen are regularly strafed by the Israeli coastguard.

Things are so absurd in Gaza that the destruction of the smuggling tunnels—used for transporting weapons as well as less sinister goods needed for daily life—was often denounced by aid officials and diplomats to me during private meetings rather than the circumstances that made them necessary in the first place.

Yet even this modest life support seems under threat. As of late April, an analysis of bilateral and multilateral aid commitments following the war revealed that donors had given only 27.5 percent of the promised $3.5 billion, or $967 million. Furthermore, only 35 percent of the aid pledged—or $1.2 billion—was actually fresh, with the majority coming from reallocated donations and emergency funding delivered as the bombs were still falling on Palestinians in Gaza. Of this new aid, just 13.5 percent—or $165 million—has come through.

Meanwhile, Gaza’s unemployment rate now stands at 44 percent—the world’s highest level—11 points higher than before the war. The unemployment rate among youth has reached 60 percent, highest in the Middle East. And 40 percent of Gaza’s nearly 1.8 million Palestinians live in poverty, even though around 80 percent received some sort of aid

This subjugation of the population to decades of international aid doesn’t have to continue.

Plans are afoot to relocate Bedouin communities to an area north of Jericho and to open an East-West corridor, inaccessible to Palestinians, stretching from East Jerusalem to the Dead Sea, essentially cutting the West Bank in half. Aid agencies, MSF included, refuse to participate in any fashion – by building new shelters for the Bedouins, for instance – to the inevitable forced relocation.

There is nothing on the table internationally that would offer a political solution for the Israeli-Palestinian conflict any time soon. Speaking to Palestinians, hopelessness is as pervasive as the concrete and barbwire encasing Gaza and the West Bank.Confronted with more than 600,000 settlers in East Jerusalem and the West Bank, they see few prospects for a Palestinian state, let alone the easing of travel restrictions. And in Gaza, the 1.8 million residents just try to get through the day.

Aiding & Abetting

Whether it is the nightly incursions and detentions without charges in and around Nablus, the maze of walls and checkpoints in Hebron, the partition of Jerusalem that cuts off access to medical care for Palestinian villages, or the deadly aerial bombardment and blockade in Gaza, the occupation takes many forms—all inevitably justified through a public discourse of security for Israelis.

This is a narrative accepted, enabled, and subsidized through international aid and failed peace processes. It has reduced “progress” in the Israeli-Palestinian conflict to young women who can finish sentences without crying, the number of truckloads of cement allowed to enter Gaza, or the Palestinian medical transfers facilitated through the Erez Crossing.

Israeli fears of rocket fire from Gaza are evidenced in the trauma of air raid sirens and the necessity, now part of Israeli building codes, for homes to have bomb shelters. The ongoing threat of tunnel-enabled attacks inside Israel also precipitates anxiety amongst those in the areas bordering Gaza.

But these fears cannot justify the devastating medical and psychological consequences for Palestinians of the barriers, checkpoints, bombing campaigns, blockades, and incursions. These measures to protect Israelis must be examined today in terms of their humanitarian fallout. Israelis and supporters of Israel must question and confront the human costs of the policies used to achieve this security. And the governments and international institutions either explicitly or tacitly supporting these policies must do the same, because the devastation they have wrought is undeniable

Humanitarian Complicity?

MSF teams in the Occupied Palestinian Territories and other war zones around the world are always reflecting on their actions with an eye toward ensuring aid does not do more harm than good. For now, we will continue stitching up the physical and psychological wounds of Palestinians, knowing that another war with Israel may not be far off, and that a great many people already need assistance right now.

This is our role, one constantly questioned by our medical teams on the ground, who are always struggling to see the invisible line between complicity with the occupation and a refusal not to ignore its consequences. Ultimately, though, our humanitarian action has been consistently justified as a response to the needs of Palestinians trapped by this endless war.

As has been the case for the past 15 years, our presence is our protest in the face of an occupation that has taken on a near-permanent character. While there is no shortage of suffering in Gaza and the West Bank, an international acceptance of the unacceptable is now the deadliest form of the occupation for Palestinians—with no end in sight.

Gaza Community Mental Health Program’s (GCMHP) Deputy Director General for Professional Affairs Taysir Diab Thursday said around 51% of Gaza’s children and 31% of its adults suffer Post-Traumatic Stress Disorder as a result to the latest Israeli mass attack on the besieged Gaza Strip.

These results were presented following a series of activities organized by the program to test the psychological condition and mental health of Gaza’s community; including children and adults.

According to WAFA Palestinian News & Info Agency, Diab along with Head of External Affairs and Resources Development Department Husam El-Nounou met with a delegation from the GIZ, which included the Regional Director of GIZ Rudolf Rogg, accompanied with GIZ Gaza-Representative Wael Safi.

The meeting, held in the GCMHP’s headquarters in Gaza, aimed at strengthening the means of joint cooperation between the GCMHP and the GIZ.

GCMHP’s Director General Yasser Abu Jamei warmly welcomed the visiting delegation, giving a brief about key activities and services provided by the GCMHP to the Palestinian community through its therapeutic and psychological interventions, in addition to its advocacy efforts, and developing the skills of professionals working in the field of community mental health.

Showing evidence and statistics collected from research and studies, Abu Jamei reaffirmed the need to offer the Palestinian people access to many psycho social and mental health services.

GCMHP’s Director General stated that GCMHP has bought a piece of land on which its permanent headquarter, funded by the Islamic Development Bank, will be built, and it will include Gaza Community Centre and departments affiliated with the GCMHP.

Diab illustrated the reasons why a great deal of men didn’t participate in the community mental health activities carried out by GCMHP, the most important of which was the excessive anger that this segment of the society is feeling because they are homeless until now, in addition to the feeling of shame for appearing in a weaker position.

The high percentage of Palestinian families in Gaza that is suffering from mental and psychological issues is not a new topic, nor a surprising one. According to Save the Children, “Homelessness and repeated exposure to violence, coupled with soaring unemployment for parents and limited mental health support, have prevented children from recovering from the mental trauma of war.”

Save the Children CEO Justin Forsyth said in a statement, ‘Many children in Gaza have now lived through three wars in the past seven years, the last one notable for its brutality. They are emotionally and, in some cases, physically shattered.”

According to the organization’s report, “An average of 75% of children surveyed experience unusual bedwetting regularly. In one area, al-Shoka, nearly half the children interviewed wet the bed every night. Up to 89% of parents reported that their children suffer consistent feelings of fear, while more than 70% of children said they worried about another war. On average seven out of 10 children interviewed suffer regular nightmares.”